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Sharing Best Practices in Strengthening Local or District Health Systems

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Abstract

Meeting the basic health needs of the people requires that governments define policies and
ensure their successful implementation at local or district level. A “health district” means a clearly
defined administrative area covering a population at whose level some form of local government or
administration takes over many responsibilities from central government departments.1
2. The concept of District Health Systems (‎DHS)‎ has been widely promoted by WHO2 in the firm
conviction that the district is the most important level for improving efficiency and responding to
local health priorities and needs with focus on high-impact health interventions. The district is in the
best position to address local challenges through seizing local opportunities and responding to
people’s health needs.
3. Experiences with decentralization in countries in the African Region have shown mixed results.
In some countries, decentralization has been accompanied by effective transfer of authority and
responsibility from the central level to the local/district level while in others weaknesses in
institutional capabilities coupled with instability in policy and environment have undermined the
performance of DHS.